Individual
MR. KEVIN LEE DIBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
259 ROSE CT N, DELMONT, PA 15626-1555
(724) 787-5708
Mailing address
259 ROSE CT N, DELMONT, PA 15626-1555
(724) 787-5708
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101293
PA
390200000X
Student in an Organized Health Care Education/Training Program
RN529489L
PA
Other
Enumeration date
10/04/2013
Last updated
01/03/2014
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